| NPI | 1265435549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 122662) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 1226621) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2009-11-05 |