| NPI | 1912490756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NC 2024-02559) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125.072709) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-09-06 |