| NPI | 1891299426 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TX V4772) | 
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.073274) | 
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: OR MD215002) | |
| Enumeration Date | 2018-03-20 | 
| Last Update Date | 2024-11-06 |