| NPI | 1548306202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MN 47295) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 47295) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2015-07-02 |