| NPI | 1831400902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA a143638) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-058204) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CO DR.0054835) | |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2023-07-21 |