| NPI | 1053720565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A139792) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 11723472-1205) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2020-06-19 |