| NPI | 1326327149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 125.059018) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: KS 04-36668) |
| 207X00000X Orthopaedic Surgery (Licence: IA MD-42289) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: PA MT202820) | |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2018-03-02 |