| NPI | 1770979247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME150101) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME150101) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 67446) | |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2023-02-10 |