| NPI | 1043621824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: PA MD461973) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD461973) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA A171688) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2022-08-02 |