| NPI | 1659522324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: MI 5101019945) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA OS014230) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2021-06-07 |