| NPI | 1619919115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: VA 0101264565) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 200100486) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2023-03-07 |