| NPI | 1982053716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD469750) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT211214) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-09-08 |