| NPI | 1568774206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME127889) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 279194) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD450054) | |
| 207X00000X Orthopaedic Surgery (Licence: PA mt198089) | |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2021-03-31 |