| NPI | 1205870441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MI 4301075858) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301075858) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-12-29 |