| NPI | 1689661464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 135225) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 135225) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 135225) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 135225) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2014-09-11 |