| NPI | 1134142714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 158554) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 29668) |
| 174400000X Specialist (Licence: NY 158554) | |
| 174400000X Specialist (Licence: CT 29668) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-06-19 |