| NPI | 1326375353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 281001) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 22300) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CT 053779) | |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2016-10-03 |