| NPI | 1528266178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A118205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 229626) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD434454) | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2021-12-14 |