| NPI | 1104318872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 036.180609) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MA 275244) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2026-08-25 |