| NPI | 1366702326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IA 45516) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301100390) |
| 207X00000X Orthopaedic Surgery (Licence: SD 10888) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2021-06-01 |