| NPI | 1538468160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME130538) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MD D80962) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2018-05-10 |