| NPI | 1982809240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: NC 2019-02773) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 236738) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2019-02773) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: TN 2433) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-01-09 |