| NPI | 1962562827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA MD426346) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 244075) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD426346) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NY 244075) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME153424) | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: NJ 25MA09224800) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2022-02-25 |