| NPI | 1861700288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: MD D74678) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-243579) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2012-09-13 |