| NPI | 1508181769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME128077) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR FE171731) |
| 207X00000X Orthopaedic Surgery (Licence: IL 125.057647) | |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2017-03-01 |