| NPI | 1033369343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-003282) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: IL 085-003282) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2018-01-08 |