| NPI | 1295398329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35144372) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.144372) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2024-01447) | |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2025-08-06 |