| NPI | 1831487396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: MO 2016015320) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 068433) |
| 207X00000X Orthopaedic Surgery (Licence: AR E-11856) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2025-05-05 |