| NPI | 1124488572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO DR.0066957) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A146327) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO DR.0066957) | |
| Enumeration Date | 2016-02-27 |
| Last Update Date | 2026-06-12 |