NPI | 1841639317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: AZ 7858) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 7858) |
207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA OP60828397) | |
Enumeration Date | 2013-06-18 |
Last Update Date | 2022-07-26 |