| NPI | 1518184605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 253594) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 261022) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD13195) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-10-27 |