| NPI | 1013089663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA C54969) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00032538) |
| 207X00000X Orthopaedic Surgery (Licence: CA C54969) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD00032538) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-08-15 |