| NPI | 1164485306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 260330-1) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 260330-1) |
| 208600000X Surgery (Licence: NC 200301052) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2021-07-29 |