| NPI | 1184967218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2019008874) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2019008874) | 
| 207X00000X Orthopaedic Surgery (Licence: GA 080288) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 125-062741) | |
| Enumeration Date | 2013-03-27 | 
| Last Update Date | 2020-10-01 |