| NPI | 1578784591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2008-00472) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A85853) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-01-08 |