| NPI | 1013235423 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: ID M-13346)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q2445)  | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX Q2445)  | |
| Enumeration Date | 2010-05-10 | 
| Last Update Date | 2022-08-23 |