| NPI | 1912940941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: GA 035537) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: GA 035537) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-07-27 |