| NPI | 1184605859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: AZ 25183) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 25183) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2016-09-09 |