| NPI | 1376520023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI CLA00005) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX 43002) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX 43002) | |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2011-04-27 |