| NPI | 1407152325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 285108) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 201500977) |
| Enumeration Date | 2011-02-10 |
| Last Update Date | 2017-03-26 |