| NPI | 1730395542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MS 22222) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 22222) |
| 207X00000X Orthopaedic Surgery (Licence: MS 22222) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-10-06 |