| NPI | 1699118869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME151311) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A152322) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA10482700) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2021-08-25 |