| NPI | 1558586834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: CA A52449) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A52449) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2025-09-11 |