NPI | 1215386628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IL 125078089) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: SC LL39592) |
Enumeration Date | 2016-06-07 |
Last Update Date | 2021-06-10 |