| NPI | 1316157449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: LA MD.204613) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.010257) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2011-11-03 |