| NPI | 1336136837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS8216) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2014-00139) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2026-10-13 |