| NPI | 1205368115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS022193) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036163845) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-09-13 |