| NPI | 1104873918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NE 23281) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NE 23281) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2021-03-02 |