| NPI | 1053505958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 52577) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 52577) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2020-11-03 |