| NPI | 1508913476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2007-01152) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 39666) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2007-01152) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2023-08-16 |