| NPI | 1649267899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CT 027311) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 27311) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2026-05-12 |