| NPI | 1952388712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 7449) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NH 7449) |
| 207X00000X Orthopaedic Surgery (Licence: VT 0420007597) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2017-05-08 |