| NPI | 1912148438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A105814) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 239018) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2021-11-29 |