| NPI | 1144249541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 199329) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 199329) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2021-04-26 |