| NPI | 1831170778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 3542238) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 321423) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2023-03-17 |