| NPI | 1386684314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 250069-1) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT 250069-1) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 250069) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2015-07-14 |