| NPI | 1215930912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME116721) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME116721) |
| 207X00000X Orthopaedic Surgery (Licence: OH 79524) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 79524) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2023-02-10 |