| NPI | 1437162815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101056168) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2005-01511) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: VA 0101056168) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2021-02-03 |