| NPI | 1710140595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MD D93297) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: DC MD210001729) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101255899) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-03-30 |