| 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 |