| NPI | 1558537951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MA 259000) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT190275) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD444412) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 68935) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2020-05-29 |