| NPI | 1154988632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD61526478) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 279561) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2024-05-23 |