| NPI | 1043834559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101290507) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4351046015) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A200739) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101290507) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2026-08-14 |