| NPI | 1043692585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036.157276) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 125067483) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 305029) | |
| Enumeration Date | 2015-06-21 |
| Last Update Date | 2021-09-02 |