NPI | 1811907017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 150904-1) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 150904-1) |
207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 150904-1) | |
Enumeration Date | 2006-08-09 |
Last Update Date | 2014-08-20 |