| NPI | 1194794925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101257473) | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA md066598l) | 
| Enumeration Date | 2006-03-15 | 
| Last Update Date | 2020-09-15 |