| NPI | 1306929302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 269448) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NY 269448) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2013-05-10 |