| NPI | 1356335079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO 2014031720) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN DO730) |
| 207X00000X Orthopaedic Surgery (Licence: IL 036120318) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2022-07-21 |