| NPI | 1538276357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101236779) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 272468) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2021-11-19 |