| NPI | 1487018925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036161899) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: IL 036161899) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2022-09-29 |