| NPI | 1235169863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 22644) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 022644) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CT 22644) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2014-04-01 |