| NPI | 1619902707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME161780) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101230890) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME161780) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101230890) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-12-19 |