| NPI | 1194082016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 272563) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H83251) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2022-04-20 |