| NPI | 1689635989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 29410) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 29410) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2025-05-15 |