| NPI | 1457386211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 208586) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 208586) |
| 207X00000X Orthopaedic Surgery (Licence: NY 208586) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-02-01 |