| NPI | 1609805910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A68008) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: CA A68008) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2016-03-11 |