| NPI | 1588636245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 258112) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 002905) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2021-04-22 |