| NPI | 1396198172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 330849) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA11351200) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11351200) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 330849) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2024-08-08 |