| NPI | 1023548443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME162875) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.069872) |
| 207X00000X Orthopaedic Surgery (Licence: CA A176347) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A176347) | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2023-08-25 |