| NPI | 1477685816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2016-02576) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL 37903) |
| 207X00000X Orthopaedic Surgery (Licence: MA 242555) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 263461) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MI 4301102211) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 263461) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-03-22 |