| NPI | 1356439251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35.052173) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35052173) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-05-26 |