| NPI | 1386084010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 297955) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 69609) |
| 207X00000X Orthopaedic Surgery (Licence: NY 297955) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2021-10-22 |