| NPI | 1346341005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX K8748) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K8748) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX K8748) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2026-08-21 |