| NPI | 1508124439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NY 286998) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101262524) |
| 207X00000X Orthopaedic Surgery (Licence: NY 286998) | |
| Enumeration Date | 2012-04-28 |
| Last Update Date | 2023-08-04 |