| NPI | 1316910490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TX N0893) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD H0063452) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MB09228900) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2014-11-19 |