| NPI | 1902339344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: FL ME156336) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME156336) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2023-07-05 |