| NPI | 1992867634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: SC 684) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: GA 053743) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NC 9401197) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2010-03-16 |