| NPI | 1780668780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 341339) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: GA 057862) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 057862) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2026-01-15 |