| NPI | 1629508866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 96066) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 271727) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 70840) | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2024-01-23 |