| NPI | 1508187741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 278138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA l-243907) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2016-08-16 |