| NPI | 1750873675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 325372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301115136) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-11-08 |