| NPI | 1528128030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: PA MD425644) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: NJ 25MA08527400) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-01-14 |