| NPI | 1902972250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX F1850) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX F1850) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-31 |