| NPI | 1225419732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: NV 22410) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 22410) |
| 207X00000X Orthopaedic Surgery (Licence: MA 283375) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 12240900-1205) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NV 22410) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-08-02 |