| NPI | 1922034537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 53114) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 5995813-1205) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: GA 53114) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2023-12-04 |