| NPI | 1275737280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 119676) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NY 247323) |
| 207X00000X Orthopaedic Surgery (Licence: NY 247323) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD432648) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2017-03-01 |