| NPI | 1831652916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 341586-01) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 341586-01) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2026-07-07 |