| NPI | 1861802126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: SC 83948) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60931686) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2023-03-30 |