NPI | 1811992183 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G62470) |
Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: CA G62470) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2015-10-08 |