| NPI | 1659535706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: SC TL33789) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY R1278) |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: NY 257503-1) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2015-09-14 |