| NPI | 1659469641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 112796) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 028526) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 112796) | |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CT 028526) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-08-01 |