| NPI | 1821107756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD60002211) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WA ML20007796) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-03-24 |