| NPI | 1073927091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 85499) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2014018997) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 11262248-1205) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2021-04-15 |