| NPI | 1295737112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 151592) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 151592) |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 151592) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 15192) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2025-09-11 |