| NPI | 1336777101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD492737) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA12926700) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD492737) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA12926700) | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2026-07-01 |