| NPI | 1356326300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: CO 23258) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO 23258) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2009-08-12 |