| NPI | 1437210887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 009826) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9103810) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-11-14 |