| NPI | 1376771634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 258690) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 053956) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 258690) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CT 053956) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2017-02-15 |