| NPI | 1558814053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME152598) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A139287) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NY 308119) | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2023-08-13 |