| NPI | 1356661680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: FL ME132405) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2015-00360) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: IL 036.141462) | |
| 207X00000X Orthopaedic Surgery (Licence: IL 125.057652) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2021-04-27 |