NPI | 1811077894 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA MD00011315) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA MD00011315) |
207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery (Licence: WA MD00011315) | |
Enumeration Date | 2006-10-16 |
Last Update Date | 2011-09-28 |