| NPI | 1508040304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A109524) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CT none) |
| 207X00000X Orthopaedic Surgery (Licence: MA 236488) | |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-02-17 |