| NPI | 1619266913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 88505) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 289254) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2022-12-27 |