| NPI | 1619359452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME153425) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME153425) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2022-07-08 |