| NPI | 1326088386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 216371) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 212659) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2020-12-10 |