| NPI | 1689301368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 316870) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: NY 316870) |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NY 316870) | |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2023-12-04 |