| NPI | 1811048838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 248226) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 215227) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2011-02-23 |