| NPI | 1164914198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: UT 13293932-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.072749) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2023-08-23 |