| NPI | 1700232501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036159869) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2021-02428) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2022-08-26 |