| NPI | 1972728400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: OH 35.095437) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 036123170) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2021-01-13 |