| NPI | 1720052079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: TX J1815) |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: TX J1815) |
| 207X00000X Orthopaedic Surgery (Licence: TX J1815) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2012-09-18 |