| NPI | 1669655650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A125226) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: OH 35.124437) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2024-12-04 |