| NPI | 1588644116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101254866) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 185796) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2015-09-29 |