| NPI | 1710283965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA09763700) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 269361) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2020-02-05 |