| NPI | 1790919124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL 165837) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX Q4466) |
| 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: NY 288799) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2024-04-03 |