| NPI | 1992773154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VT 042.0011289) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 228215) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-09-15 |