| NPI | 1255564696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA TR60075626) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA TR60075626) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2009-09-02 |