| NPI | 1962846931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 330555) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: RI MD17144) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: LA 329062) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-07-05 |