| NPI | 1558560573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME116718) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 265975-1) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME116718) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2025-04-09 |