| NPI | 1396063640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 76442) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD452869) |
| 207X00000X Orthopaedic Surgery (Licence: GA 76442) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2021-02-10 |