| NPI | 1871148478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: IL 085.007490) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2023-06-16 |