| NPI | 1003254822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MA 282711) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036.148560) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD463368) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-09-01 |