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 |