| NPI | 1316567407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2026-02292) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: SC MD94449) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2026-02292) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2026-07-28 |