| NPI | 1932563327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD478001) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25MA11498300) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD478001) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.142558) | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2024-05-21 |