| NPI | 1538102124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME 103708) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 33956) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME103708) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 33956) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-04-19 |