| NPI | 1770900730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 304171) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 66352) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2021-08-03 |