| NPI | 1730716861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 79715) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 261050) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2025-09-25 |