| NPI | 1154684645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX R1755) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX BP10044556) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2023-08-07 |