| NPI | 1356451249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD60836624) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD60836624) |
| 207X00000X Orthopaedic Surgery (Licence: ID M10842) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2018-10-18 |