| NPI | 1194021394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 182427) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NY 182427) |
| 209800000X Legal Medicine (Licence: NY 182427) | |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |