NPI | 1750437828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 2030161) |
Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 2030161) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 2030161) | |
Enumeration Date | 2007-01-25 |
Last Update Date | 2016-02-29 |