| NPI | 1164410270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2016039011) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 47050) |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: KY 32272) | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2021-03-09 |