| NPI | 1417219510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD61141013) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: VA 0101256116) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2021-05-26 |