| NPI | 1982860573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: OH 35.126478) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WI 55350) |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: IL 036-128640) | |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2015-08-03 |