| NPI | 1063623353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD476433) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 48402) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35-091691) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2023-01-18 |