| NPI | 1477520575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 11453) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: UT 11034571-1205) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2019-03-27 |