| NPI | 1649259946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NY 291527) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036112798) |
| 207X00000X Orthopaedic Surgery (Licence: MA 226241) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2021-04-15 |