| NPI | 1518976174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 241744) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI 13229) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2025-05-29 |