| NPI | 1023245644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD60931365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60931365) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2020-11-08 |