| NPI | 1265725535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WV 25335) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35131937) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2021-11-17 |