| NPI | 1588697700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OH 35-085087) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: KY 39372) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: KY 39372) | |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: OH 35-085087) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-04-16 |