| NPI | 1639324049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: UT 7152057-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: UT 7152057-1205) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD445881) | |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2022-11-08 |