| NPI | 1457797276 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CT 62500) | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 080123) | 
| 207X00000X Orthopaedic Surgery (Licence: CT 62500) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MA 1013032) | |
| Enumeration Date | 2013-05-20 | 
| Last Update Date | 2024-11-20 |