| NPI | 1700383486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 105593) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A195139) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A195139) | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2026-04-07 |