| NPI | 1487622510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 29072) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 64057) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA G73906) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WI 64057-20) | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-07-23 |