| NPI | 1871884437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MI EMC0000651) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 67494-20) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.128329) | |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2023-08-10 |