| NPI | 1275074619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301508779) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.070093) |
| 207X00000X Orthopaedic Surgery (Licence: MI 4301508779) | |
| Enumeration Date | 2017-03-18 |
| Last Update Date | 2023-08-23 |