| NPI | 1679826028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOUGALD MACGILLIVRAY Owner 212-606-1896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 188511) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: VT 042-0010337) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CT 039252) | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-12-12 |