| NPI | 1710939681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CA G39051) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G39051) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2009-02-11 |