| NPI | 1073732392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NC 2013-00347) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 76520) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2013-04-04 |