| NPI | 1619970654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NM 93-29) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM 93-29) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2019-03-12 |