| NPI | 1578054383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: PA MD480419) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL52466) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-08-04 |