| NPI | 1588874861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 237110) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 047908) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-10-16 |