| NPI | 1801019666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MS 19233) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NC 2009-00385) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2019-05-31 |