| NPI | 1255302261 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2018009511) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME 62326) | 
| 207X00000X Orthopaedic Surgery (Licence: MO 2018009511) | |
| Enumeration Date | 2006-01-28 | 
| Last Update Date | 2024-06-26 |