| NPI | 1043545965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 35038) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI 13572) |
| 207X00000X Orthopaedic Surgery (Licence: NY 252910) | |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2020-05-29 |