| NPI | 1598778789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME134541) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036082146) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-02-04 |