| NPI | 1598103913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MN 63761) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 63761) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2019-07-19 |