| NPI | 1750362323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NV 9784) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NV 9784) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2018-09-17 |