| NPI | 1093918245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX P1746) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 57.010466) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: TX P1746) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2013-07-08 |