| NPI | 1114131786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2011-00161) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101249026) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101249026) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2016-04-12 |