| NPI | 1801322953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR MD214370) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-10844) |
| 207X00000X Orthopaedic Surgery (Licence: NY 316839) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-09-23 |