| NPI | 1306003975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 246695) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 246695) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX N6259) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-03-02 |