| NPI | 1053389726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AR E1571) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 110164-1) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-10 |