| NPI | 1114433414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY P09809) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 1-35077) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2018-05-02 |