| NPI | 1407371545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MO 2021043413) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2021043413) |
| 207X00000X Orthopaedic Surgery (Licence: MN 66282) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2020019413) | |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-06-28 |