| NPI | 1679643811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 288261) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 17149) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2017-03-28 |