NPI | 1043621824 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: PA MD461973) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD461973) |
207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A171688) | |
Enumeration Date | 2014-05-14 |
Last Update Date | 2022-08-02 |