| NPI | 1306074901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: MD D81507) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125-056646) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2021-11-23 |