| NPI | 1548325467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 277349) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 245107) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101261193) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2019-07-30 |