| NPI | 1669715322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA 313139) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CO dr0054665) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: KY 313139) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-01-21 |