| NPI | 1326010430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NY 2091764) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 2091764) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: NJ 25MA08861700) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-08-15 |