| NPI | 1619389624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NJ 25MA10845800) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NY 297279) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD469853) | |
| Enumeration Date | 2014-05-25 |
| Last Update Date | 2023-11-20 |