| NPI | 1770889990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 284472) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD454050) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NJ 25MA09706000) | |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2016-10-24 |