| NPI | 1093125106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NV DO2999) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS17150) |
| 207X00000X Orthopaedic Surgery (Licence: NV SL1009) | |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2026-03-10 |