| NPI | 1538515432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 318795) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 267803) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 69912) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2024-05-13 |