| NPI | 1164970372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 326226) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 1015267) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2024-07-01 |