| NPI | 1104040922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036138653) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101237863) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2017-05-17 |