| NPI | 1730594953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: KS 0444826) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO 2020017634) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MO 2020017634) | |
| 208600000X Surgery (Licence: MO 2014020910) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2024-07-25 |