| NPI | 1689968729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OK 28579) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q8906) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX Q8906) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2022-07-21 |