| NPI | 1255627964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NV 17066) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125059818) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2016-00148) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A149150) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2021-08-11 |