| NPI | 1396016705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: LA 324217) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 324217) |
| Enumeration Date | 2012-01-16 |
| Last Update Date | 2022-05-19 |