| NPI | 1861713265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 65234) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125-058682) |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2019-10-28 |