| NPI | 1265487623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD070216L) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA07108800) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME152909) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2022-02-25 |