| NPI | 1144497959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D0070821) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 237621) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MA 239423) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: MD D0070821) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2011-10-27 |