| NPI | 1992781645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V5544) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 139017) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2026-01-28 |