| NPI | 1841461134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036-125644) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: LA MD.LSU.ORS) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MO 2010011917) | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036125644) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2022-01-14 |