| NPI | 1659834083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: ID 7771446) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 74703) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN 74703) | |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2025-09-03 |