| NPI | 1013011287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 141333) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 141333) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 141333) | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2025-09-11 |