| NPI | 1790215515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IL 036162774) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: MI 4351048842) |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 036162774) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11019225A) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-04-06 |