| NPI | 1013948058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OH 35.089259) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN MD35201) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-04-21 |