| NPI | 1457325318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD014445E) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 156432-1) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2011-04-19 |