| NPI | 1497721336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 200346) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 200346) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2022-08-18 |