| NPI | 1144539677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 270316) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 46025) |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2020-11-23 |