| NPI | 1386032589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX R8855) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: ZZ 0000000) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME137298) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX R8855) | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2023-02-17 |