| NPI | 1841216165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 279608-01) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R5P11) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-03-07 |