| NPI | 1124294962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 45461) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 282050) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2015-11-12 |