| NPI | 1326508524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: KY 60677) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 76505) |
| 207X00000X Orthopaedic Surgery (Licence: KY 60677) | |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2025-06-30 |