| NPI | 1821354176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD465257) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 275452) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2019-01-18 |