| NPI | 1164702585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL OS15764) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5101019556) |
| 207X00000X Orthopaedic Surgery (Licence: OR do186723) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2020-02-03 |