| NPI | 1033507330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HARRIS Medical Director, Sole Proprietor 347-891-1546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME111506) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: FL ME111506) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2018-04-30 |