| NPI | 1760267744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 030514) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 030514) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-08-29 |