| NPI | 1386835023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 239941) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 55621) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2019-02-07 |