| NPI | 1598701930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL ME123787) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A50293) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A50293) | |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301088730) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2017-03-28 |