| NPI | 1902221898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WY 16951A) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WY 16951A) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2024-07-25 |