| NPI | 1861409310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CO 41170) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CO DR.0041170) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-10-15 |