| NPI | 1972764561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 56170) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125049165) |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2023-06-23 |