| NPI | 1629292487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MO 2009019562) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 5101015817) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2012-08-20 |