| NPI | 1649245861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD059283L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 152761) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2011-09-16 |