| NPI | 1760609838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2008-00994) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036118196) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: NC 2008-00994) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2010-05-12 |