| NPI | 1710120282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: PA 453963) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: PA 453963) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2015-08-13 |