| NPI | 1306227632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 70068) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R-10362) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 11741886-1205) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-12-15 |