| NPI | 1609040575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036-147187) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MD438684) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IN 01082491A) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2019-12-27 |