| NPI | 1528039211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD207820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 186807) |
| 207X00000X Orthopaedic Surgery (Licence: NH 12024) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-02-10 |