| NPI | 1376791277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 248268) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA P-236524) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 248268) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 248268) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2022-08-19 |