| NPI | 1104959220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 72936) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 72936) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35-092688) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2024-05-07 |