| NPI | 1598739708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX T3745) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 133417) |
| 207X00000X Orthopaedic Surgery (Licence: SD 7833) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-08-11 |