| NPI | 1053595538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036122761) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125048399) |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2024-03-20 |