| NPI | 1922097971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery (Licence: IL 036111139) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: WV 23111) |
| 207X00000X Orthopaedic Surgery (Licence: TX M4089) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2014-04-04 |