| NPI | 1033167747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 22233) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: NE 22233) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2011-06-28 |