| NPI | 1407882921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 258093) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 002427) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2021-12-22 |