| NPI | 1013018118 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 236965) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N0005909-1) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2011-09-22 |