NPI | 1053805044 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: SC 92387) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125073293) |
Enumeration Date | 2018-06-21 |
Last Update Date | 2024-06-20 |