| NPI | 1831500172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AZ 56820) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 56820) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-09-06 |