| NPI | 1235628173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MN 74109) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A193755) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A193755) | |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2024-03-21 |