| NPI | 1417950130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 046946) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 046946) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2017-04-21 |