| NPI | 1528027166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WI 40299) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 40299) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2021-09-14 |