| NPI | 1831395052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 21934) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 282871) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2016-05-24 |