| NPI | 1306072129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME125095) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT195641) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME125095) | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2017-01-13 |