| NPI | 1093741506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 157768-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 157668) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2016-10-03 |