| NPI | 1356603260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 69859) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D85694) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MD D85694) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CT 69859) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2025-01-09 |