| NPI | 1467983874 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.148246)  | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A178095)  | 
| 207X00000X Orthopaedic Surgery (Licence: OH 57.029674)  | |
| Enumeration Date | 2017-03-27 | 
| Last Update Date | 2023-08-10 |