| NPI | 1164515243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX D7071) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX D7071) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-03-28 |