| NPI | 1689738783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M-17340) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A100400) | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A100400) | |
| Enumeration Date | 2006-12-21 | 
| Last Update Date | 2023-07-31 |