| NPI | 1225267370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 46806) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-057081) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2014-07-24 |