NPI | 1578096012 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX U3149) |
Additional Taxonomies | 174400000X Specialist (Licence: TX u3149) |
Enumeration Date | 2017-04-11 |
Last Update Date | 2023-11-14 |