| NPI | 1093767675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 232106) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 42365) |
| 174400000X Specialist (Licence: NY 232106) | |
| 207X00000X Orthopaedic Surgery (Licence: CT 045346) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 232106) | |
| 207K00000X Allergy & Immunology (Licence: NY 232106) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2014-05-08 |