| NPI | 1588644702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 184684) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 184684) |
| 207X00000X Orthopaedic Surgery (Licence: NY 184684) | |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 184684) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-03-29 |