| NPI | 1528687068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA OP61668710) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR 199617) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2025-08-06 |