| NPI | 1659766038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TN 61143) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 61143) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2025-06-25 |