| NPI | 1023074796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 047723) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA G70048) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA G70048) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2016-07-08 |