| NPI | 1770543704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS8633) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL OS8633) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-04-23 |