| NPI | 1811383110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV DO3008) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A18317) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NV DO3008) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2021-09-09 |