| NPI | 1487734802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: SC 37958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX K3635) |
| 207X00000X Orthopaedic Surgery (Licence: SC 37958) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2016-07-01 |