| NPI | 1609050202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: FL OS15175) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 34010816) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2021-12-10 |