| NPI | 1295034551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 79992) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 2453) |
| 207X00000X Orthopaedic Surgery (Licence: IL 1111) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 0000) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2023-10-18 |