| NPI | 1245328103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 150073) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 150073) |
| 207X00000X Orthopaedic Surgery (Licence: CT 28357) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CT 28357) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-09-03 |