| NPI | 1811161805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 247447) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101243496) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2014-01-23 |