| NPI | 1700349701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 347097) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 347097) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2026-09-25 |