| NPI | 1780845289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 276929) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 14718) |
| 207X00000X Orthopaedic Surgery (Licence: CA A125789) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2014-09-18 |