| NPI | 1669420428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0102202199) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 3893) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0102202199) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 3893) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-11-12 |