| NPI | 1649763947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 83493) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.071697) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2025-10-07 |