| NPI | 1902073794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OH 35 . 091434) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35 . 091434) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2015-10-02 |