| NPI | 1962551440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 148495) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TX M4792) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NE 24619) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2009-08-13 |