| NPI | 1871710756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: MA 261758) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: NH 16927) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-06-26 |