| NPI | 1871850727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: ID M-14130) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: WA MD60825859) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: GA 73555) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2021-01-28 |