| NPI | 1578881819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 278003) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NY 278003) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-02-17 |