| NPI | 1003976598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OH 35093375) |
| Additional Taxonomies | 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery (Licence: IL 036117745) |
| 207X00000X Orthopaedic Surgery (Licence: NH LT 2791) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2012-01-18 |