| NPI | 1649566456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 301272) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 20A12419) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2023-12-07 |