| NPI | 1821437757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: GA 82165) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 82165) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: SC MD52054) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-04-03 |