| NPI | 1821132374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101249032) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 257393-1) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2020-10-30 |