| NPI | 1184717985 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: DC MD15233) | 
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: DC MD15233) | 
| Enumeration Date | 2006-10-02 | 
| Last Update Date | 2012-03-15 |