| NPI | 1326429408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 318620) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 318620) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD17073) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-05-03 |