| NPI | 1548260755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA OS010724L) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: PA OS010724L) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2021-05-20 |