| NPI | 1164402707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MT 11747) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MT 11747) |
| 207X00000X Orthopaedic Surgery (Licence: WA MD00045946) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2024-11-06 |