| NPI | 1013963248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: VA 0101048297) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101048297) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101048297) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2019-08-15 |