| NPI | 1891115085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD61042333) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61042333) |
| Enumeration Date | 2014-04-26 |
| Last Update Date | 2023-09-27 |