| NPI | 1639192164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036.128125) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT185463) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-11-07 |