| NPI | 1629014675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: KY 03167) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: NY 238138) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NY 238138) | |
| 207X00000X Orthopaedic Surgery (Licence: NY 238138) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2010-07-06 |