| NPI | 1972575983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA 060732) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 45717) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME98645) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2008-09-17 |