| NPI | 1033182282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: PA MD069579L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD069579L) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2016-03-31 |