| NPI | 1659667673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 253777) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY P78081) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2014-01-06 |