| NPI | 1013208958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036148358) |
| Additional Taxonomies | 208600000X Surgery (Licence: ID 7571868) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2025-10-07 |