| NPI | 1841811213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA 21021) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IL 125085120) |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2026-04-13 |