| NPI | 1043348378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA G081777) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA GO81777) |
| 2086S0102X Surgery Surgical Critical Care (Licence: CA G081777) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2010-04-16 |