NPI | 1336567056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 280269) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036.148028) |
Enumeration Date | 2014-03-31 |
Last Update Date | 2020-12-21 |