| NPI | 1265421184 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS6080) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO DR.0056721) | 
| Enumeration Date | 2005-10-14 | 
| Last Update Date | 2023-08-02 |