| NPI | 1053578906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CO DR.0063648) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IL 036-133280) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2021-04-06 |