| NPI | 1568922722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 14217934-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 67792) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 67792) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 14217934-8905) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2025-06-10 |