| NPI | 1689727851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO R5920) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036-107507) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2017-04-06 |