| NPI | 1851355564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 243498) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 227191) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2021-04-02 |