| NPI | 1639382328 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301083727) | 
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MI 4301083727) | 
| Enumeration Date | 2007-05-08 | 
| Last Update Date | 2015-04-24 |