| NPI | 1063613339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NJ 25MA08348400) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 239321) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-05-14 |