| NPI | 1992022701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 284653) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 262709) |
| 207X00000X Orthopaedic Surgery (Licence: NY 284653) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2021-01-20 |