| NPI | 1134123656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 049867) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY 261498-1) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036060200) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2013-09-16 |