| NPI | 1790775831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: PR 4843) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PR 4843) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2010-11-03 |