| NPI | 1093135774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35.139659) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2019011449) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2019011449) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.139659) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2020-10-26 |