| NPI | 1134399090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN DO 2653) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN DO2653) |
| 207X00000X Orthopaedic Surgery (Licence: WI 64999) | |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2022-09-06 |