| NPI | 1154332377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME144090) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VT 0420011642) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2021-03-18 |