| NPI | 1861611816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036.120944) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NJ 25IA12837800) |
| 207X00000X Orthopaedic Surgery (Licence: NE 24126) | |
| 207X00000X Orthopaedic Surgery (Licence: WI 2935) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2025-12-05 |