| NPI | 1073522652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 258179) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 97677) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME 97677) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-07-06 |