| NPI | 1477887313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AL 19257) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 19257) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |