| NPI | 1720387046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202C00000X Independent Medical Examiner (Licence: NY 108462) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 108462) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2011-03-25 |