| NPI | 1992023071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA 446739) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 073502) |
| 207X00000X Orthopaedic Surgery (Licence: NY 283309) | |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-03-04 |