| NPI | 1881894178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35.095076) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.095076) |
| 207X00000X Orthopaedic Surgery (Licence: OH 57.010272) | |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2021-03-15 |