| NPI | 1265424485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WI 43873-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 43873-20) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2022-07-22 |