| NPI | 1710186770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: FL ME109120) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125051441) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2016-08-28 |