| NPI | 1053528752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: SC 33964) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD425113) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: LA MD.202405) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: SC 33964) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2024-12-23 |