| NPI | 1508350190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 83058) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.071824) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-12-16 |