| NPI | 1447248836 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME100011)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 213565)  | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME100011)  | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 213565)  | |
| Enumeration Date | 2005-10-10 | 
| Last Update Date | 2019-03-21 |