| NPI | 1528051018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CO 37762) |
| Additional Taxonomies | 207XX0801X Orthopaedic Surgery, Orthopaedic Trauma (Licence: CO 37762) |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: CO 37762) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2013-11-14 |