| NPI | 1649641960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 298757-1) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IA R - 10452) |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2023-10-13 |