| NPI | 1275894214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA A149350) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60876991) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD60876991) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OR MD192346) | |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2023-01-04 |