| NPI | 1164643201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2018031625) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-050306) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2018-10-10 |