| NPI | 1588922728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 93579) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 295921) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 295921) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2022-11-14 |