| NPI | 1609056647 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 43049) | 
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: AZ 43049) | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 43049) | |
| Enumeration Date | 2007-11-07 | 
| Last Update Date | 2020-04-14 |