| NPI | 1174751440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 125-057028) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CO 53743) |
| 207X00000X Orthopaedic Surgery (Licence: OH 35126856) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036-147487) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2019-01-16 |