| NPI | 1184912909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 50633) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-060504) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2023-12-12 |