| NPI | 1508151499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11149700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10039661) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 287826-1) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CT 60101) | |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2024-05-02 |