| NPI | 1528484417 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA OP61361309) | 
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: KS 05-43201) | 
| Enumeration Date | 2014-03-15 | 
| Last Update Date | 2023-01-18 |