| NPI | 1902870934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 309442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 027867) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2021-04-21 |