| NPI | 1174813026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX S8986) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA 307239) |
| 208600000X Surgery (Licence: IL 126060526) | |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2020-12-15 |