| NPI | 1619947413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: GA 71342) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NE 22952) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: TX N4431) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-08-01 |