| NPI | 1326044686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 319067) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NM 2005-0142) |
| 207X00000X Orthopaedic Surgery (Licence: SC 21387) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 21387) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2022-10-07 |