| NPI | 1568801025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 70102) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036144643) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2022-05-11 |