| NPI | 1669687000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 210288) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH 8082) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2007-07-08 |