| NPI | 1891058368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OH 35.133870) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MI 4301101292) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-10-25 |