| NPI | 1821433210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036145036) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: LA 312202) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2022-02-21 |