| NPI | 1053561449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MI 4301105117) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.014767) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2021-07-08 |