| NPI | 1316936842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD469347) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 221155) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2021-03-15 |