| NPI | 1063503217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 297330) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 35464) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2019-06-25 |