| NPI | 1467611608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL 172242) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 280176-) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 280176) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2025-09-18 |