| NPI | 1669454625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: NY 181147) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: NY 181147) |
| 207X00000X Orthopaedic Surgery (Licence: NY 181147) | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma (Licence: NY 181147) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2008-02-15 |