| NPI | 1770521551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AL 20900) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AL 20900) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AL 20900) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2024-05-07 |