| NPI | 1285697094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: FL ME79431) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME79431) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2018-03-17 |