| NPI | 1316997786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MO 110638) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 110638) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: KS 04-19849) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2016-02-09 |