| NPI | 1952339913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 198084) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 11-3372638) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2011-05-19 |