| NPI | 1104847789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD026953E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD026953E) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-03-13 |