| NPI | 1033365457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 257627) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA VA0101245124) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101245124) | |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2025-05-28 |