| NPI | 1043767734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD456673) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 287870) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2018-07-19 |