| NPI | 1659878841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 1013201) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MI 4301510989) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2024-07-29 |