| NPI | 1023063989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME145684) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD61000908) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AL 14668) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-05-24 |