| NPI | 1750372173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 206042-1) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 206042-1) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 206042-1) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2013-12-19 |