| NPI | 1780093807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN FIELDS Practice Manager 185-877-7465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 2143821) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2019-01-09 |