| NPI | 1134388697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 259356) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 259356) |
| 207X00000X Orthopaedic Surgery (Licence: CT 53196) | |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2020-12-31 |