| NPI | 1003858028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 20331) |
| Additional Taxonomies | 174400000X Specialist (Licence: MN 20331) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-04-08 |