| NPI | 1811335748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: NY 313782) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-063179) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2022-03-15 |