| NPI | 1982086831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A169159) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT208668) |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2022-02-07 |