| NPI | 1568758951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101262789) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KY 49233) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101262789) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-03-02 |