| NPI | 1215000302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MO 2005005180) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A83197) |
| 207X00000X Orthopaedic Surgery (Licence: MO 2005005180) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2012-04-19 |