| NPI | 1134387889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: VA 0101247548) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 244859) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2010-08-26 |