NPI | 1912904053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TX G4110) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX G4110) |
Enumeration Date | 2005-07-05 |
Last Update Date | 2024-08-06 |