| NPI | 1043324544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: TX S5578) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX S5578) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2024-06-10 |