| NPI | 1811302102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NV 20838) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT205932) |
| 207X00000X Orthopaedic Surgery (Licence: NV 20838) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2021-03-02 |