| NPI | 1073968293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036160237) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036160237) | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2025-04-14 |