| NPI | 1295844074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA G79283) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA G79283) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2009-02-26 |