| NPI | 1356322630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX N8252) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301071762) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2013-01-29 |