| NPI | 1083681621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD030417E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY MD199841) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2020-04-27 |