NPI | 1013402874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: IL 036173853) |
Additional Taxonomies | 208600000X Surgery (Licence: MI 4351045078) |
208600000X Surgery (Licence: AZ R77048) | |
Enumeration Date | 2018-06-25 |
Last Update Date | 2025-08-31 |