| NPI | 1205324423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 301938) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 301938) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-09-22 |