| NPI | 1306153572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: LA 311786) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A136713) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2021-05-21 |