| NPI | 1134342918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2010008612) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OR MD25835) |
| 207X00000X Orthopaedic Surgery (Licence: IL 36.127269) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-07-16 |