| NPI | 1205199346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NH 18958) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125061566) |
| 207X00000X Orthopaedic Surgery (Licence: PA MD460380) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2018-08-27 |