| NPI | 1811382690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 332138) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 209697) |
| 207X00000X Orthopaedic Surgery (Licence: MD D92114) | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NC 209697) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 209697) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NC 209697) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-09-20 |