| NPI | 1104386267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MD D0103621) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD600004322) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-08-12 |