| NPI | 1376647891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 241604-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 241604-1) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-04-08 |