| NPI | 1700204492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 284064) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD16741) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA 284064) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2025-05-21 |