| NPI | 1497721153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2020-1784) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 180888) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2024-04-02 |