| NPI | 1922257237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: FL ME113764) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 245113) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME113764) | |
| Enumeration Date | 2008-09-10 |
| Last Update Date | 2014-09-16 |