| NPI | 1437248622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: VA 0101057794)  | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 22687)  | 
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: VA 0101057794)  | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WV 22687)  | |
| Enumeration Date | 2006-10-12 | 
| Last Update Date | 2018-07-05 |