| NPI | 1275092108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: UT 13877446-1205) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 1275092108) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-03-09 |