| NPI | 1982136016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NY 316752) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 316752) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2023-06-07 |