| NPI | 1326244799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME145066) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0116017794) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME145066) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 253715) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2021-03-26 |