| NPI | 1649419672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 4070) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036121696) |
| Enumeration Date | 2009-02-15 |
| Last Update Date | 2010-09-28 |