| NPI | 1568438075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 214176) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 22903) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2013-07-10 |