| NPI | 1003377755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX T2424) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX T2424) |
| 207X00000X Orthopaedic Surgery (Licence: NY 328251) | |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2025-06-06 |