| NPI | 1649409368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 062383) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC 38906) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 062383) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2019-10-25 |