| NPI | 1124399449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 75491) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036139529) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036139529) | |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2021-12-06 |