NPI | 1376885467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NY 276191) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036144907) |
Enumeration Date | 2013-03-27 |
Last Update Date | 2020-12-30 |