| NPI | 1740272798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 25430) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 24530) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-06-22 |