| NPI | 1386900652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AZ 66890) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036147079) |
| 207X00000X Orthopaedic Surgery (Licence: NC 2017-00214) | |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: IL 036147079) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2023-08-09 |