| NPI | 1881676682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 200301019) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2003-01019) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2010-05-12 |