| NPI | 1467611608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 280176-) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NY 280176) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2015-08-31 |