| NPI | 1124409032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA T287904) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-066853) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: RI MD17601) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD469688) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA10793800) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2021-09-07 |