| NPI | 1316060148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IL 036-118114) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036118114) |
| 207X00000X Orthopaedic Surgery (Licence: FL ME119307) | |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: FL ME119307) | |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2016-12-02 |