| NPI | 1699753814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 217380) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 2173801) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 217380) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2013-06-25 |