| NPI | 1366544017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 252452) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 46697) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2021-03-30 |