| NPI | 1114121969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036127202) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2006020074) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 036127202) | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IA 39450) | |
| 207X00000X Orthopaedic Surgery (Licence: IA 39450) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2011-08-15 |