| NPI | 1518054949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 241602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 241602) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-07-05 |