| NPI | 1891793410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101231225) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101231225) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101231225) | |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2021-02-04 |