| NPI | 1730168626 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: KS 04-43974) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 46861) |
| 207X00000X Orthopaedic Surgery (Licence: MN 46861) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2021-11-12 |