NPI | 1801101209 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036.137441) |
Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: TX P3283) |
Enumeration Date | 2010-08-10 |
Last Update Date | 2022-07-26 |