| NPI | 1174056907 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX U5390) | 
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036159742) | 
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01087841A) | |
| Enumeration Date | 2017-04-08 | 
| Last Update Date | 2023-07-31 |