| NPI | 1568807022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AZ 55480) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OK 30037) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2020-08-12 |