| NPI | 1588956601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 284353) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 384353) |
| Enumeration Date | 2011-05-08 |
| Last Update Date | 2017-09-08 |