| NPI | 1316033426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 149220) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 39238) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: CT 039238) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 149220) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-12-18 |