| NPI | 1679537476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 281009) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 62204-20) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 281009) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2015-08-31 |