| NPI | 1134623598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 329931) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 1013324) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-06-26 |