| NPI | 1558688697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2019-02618) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OR MD175886) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: PA MD453311) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NJ 25MA09674100) | |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2025-01-23 |