NPI | 1639431802 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A146581) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 310072) |
207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 310072) | |
Enumeration Date | 2012-06-13 |
Last Update Date | 2025-09-04 |