| NPI | 1356484174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 146-658) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 146658) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2018-08-21 |