| NPI | 1649250671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AL MD11298) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MO R4N11) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AL MD11298) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2014-05-06 |