| NPI | 1902300643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101282676) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 322624) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2025-07-14 |