| NPI | 1770947665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036.163387) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: CO 2345467) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2023-06-09 |