| NPI | 1114930781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 363213-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A79409) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A79409) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2025-02-13 |