| NPI | 1811485881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.150923) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 320071) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2024-05-20 |