| NPI | 1093765950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 181664) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 030654) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-06-22 |