| NPI | 1477814671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 68975) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 57352) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN 57352) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-07-29 |