| NPI | 1740231463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: VA 0101221394) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101221394) |
| 207X00000X Orthopaedic Surgery (Licence: VA 0101221394) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-08-14 |