| NPI | 1689953705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL ME116733) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL ME116733) |
| 207X00000X Orthopaedic Surgery (Licence: NM 2012-0460) | |
| 207X00000X Orthopaedic Surgery (Licence: GA 066684) | |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2019-06-21 |