| NPI | 1710274147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX q9068) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA 198983) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2017-05-10 |