| NPI | 1548444508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA09115500) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD445496) |
| 207X00000X Orthopaedic Surgery (Licence: NJ 25MA09115500) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 245955-1) | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2020-06-14 |