NPI | 1063432888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD000188830) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00018830) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2011-12-14 |