| NPI | 1962064378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 298-822) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 298-822) |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2019-07-05 |