| NPI | 1366503674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 21513) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 21513) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-02-13 |