| NPI | 1891922894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD452143) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301094371) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PA MT205542) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2023-06-27 |