| NPI | 1164778361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.125271) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.125271) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: OH 35.125271) | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2016-04-04 |