| NPI | 1659695302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 262818) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 54986) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2021-04-09 |