| NPI | 1740418912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: RI 14552) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX Q3047) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-11-20 |