| NPI | 1982677829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 156399) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 067744) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-04-20 |