| NPI | 1891776068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: TN 1736) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 036-121694) |
| 207X00000X Orthopaedic Surgery (Licence: MI 5101013131) | |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2025-10-08 |