| NPI | 1578091088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN 67954) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 99645) |
| 207X00000X Orthopaedic Surgery (Licence: IA R-10863) | |
| 207X00000X Orthopaedic Surgery (Licence: KY 56957) | |
| Enumeration Date | 2017-05-28 |
| Last Update Date | 2025-05-07 |