| NPI | 1679923528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 101143) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MS 29894) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MS 29894) | |
| 207X00000X Orthopaedic Surgery (Licence: RI MD17574) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2026-05-05 |