| NPI | 1043847973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036180502) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD489113) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-08-25 |