| NPI | 1366583213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NC 201002101) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2010-02101) |
| 207X00000X Orthopaedic Surgery (Licence: NC 201002101) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-02-08 |