| NPI | 1841242534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: VA 0101038209) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101038209) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-08-14 |