| NPI | 1013409291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 5101023817) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-164619) |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-05-02 |