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 |