| NPI | 1073757183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME114034) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A116559) |
| 207X00000X Orthopaedic Surgery (Licence: OH 57.011810) | |
| 207X00000X Orthopaedic Surgery (Licence: FL ME114034) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A116559) | |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2018-11-19 |