| NPI | 1497199020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MS 26816) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 306961) |
| 207X00000X Orthopaedic Surgery (Licence: RI MD16253) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2025-12-03 |