| NPI | 1346341005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX K8748) | 
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: TX K8748) | 
| 207X00000X Orthopaedic Surgery (Licence: TX K8748) | |
| Enumeration Date | 2006-09-26 | 
| Last Update Date | 2010-05-12 |