| NPI | 1790702223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 148060) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 148060) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 148060) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-06-14 |