| NPI | 1801852272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL OS8220) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL OS8220) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2015-05-28 |