| NPI | 1316328826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T6347) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020010834) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2020010834) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2022-08-03 |