| NPI | 1629224688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2010-00367) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NC 2010-00367) |
| 207X00000X Orthopaedic Surgery (Licence: IL 125-0474632) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2013-01-04 |