| NPI | 1619321809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 314727-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2021-01325) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2023-03-10 |