| NPI | 1811491848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 72776) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 72776) |
| 207X00000X Orthopaedic Surgery (Licence: WI 84628-20) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WI 84628-20) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-09-18 |