| NPI | 1114907060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA MD053174L) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA BN4554398) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD053174L) | |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-01-08 |