| NPI | 1447416003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: FL ME108788) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-049640) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2024-09-05 |