| NPI | 1972897270 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX T1835) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD461664) | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 036.140144) | |
| Enumeration Date | 2011-06-03 | 
| Last Update Date | 2024-10-10 |