| NPI | 1386956563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS017298) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 264595) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0102204011) | |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2021-04-29 |