| NPI | 1356641609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS015721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 272940) |
| 207X00000X Orthopaedic Surgery (Licence: OH 58003182) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 34.010342) | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2021-09-10 |