| NPI | 1841213972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 33552) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 28471) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: SC 28471) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2022-06-08 |