| NPI | 1225083769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VT 042-0011166) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NH LT 3183) |
| 207X00000X Orthopaedic Surgery (Licence: NH 15820) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NH LT 3183) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NH 15820) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2015-12-21 |