| NPI | 1063504843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: DE C20004245) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DE C20004245) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL OS14323) | |
| 2080S0010X Pediatrics, Sports Medicine (Licence: FL OS14323) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2017-02-07 |