| NPI | 1568672525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WI 51622-20) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IA R7126) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MN 50817) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-09-01 |