| NPI | 1376798850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 262189) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA L-237524) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 036-128263) | |
| Enumeration Date | 2008-11-25 |
| Last Update Date | 2023-03-14 |