| NPI | 1235167107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: CA G37045) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G37045) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2016-11-07 |