| NPI | 1306162375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: SC 39882) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A134398) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-10-11 |