| NPI | 1063596997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX M8573) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL trn6843) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-02-05 |