| NPI | 1720003619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA A77961) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A77961) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-10-17 |