| NPI | 1750329819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI 4301056114) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: SC MD34310) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TN 26861) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-03-26 |