| NPI | 1801891734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA G58622) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G58622) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA G58622) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-02-10 |