| NPI | 1972513554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 241608) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 002246) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-08-22 |