| NPI | 1114209541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL DO1657) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL DO.1657) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AL DO1657) | |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2024-05-07 |