| NPI | 1689624140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2004005144) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: IL 036.176707) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036.176707) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-10-03 |