| NPI | 1669413480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 231541) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 231541) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 231541) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2009-11-30 |