| NPI | 1164664199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D71915) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD436588) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MD D71915) | |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2011-08-25 |