| NPI | 1255380937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 036066339) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 41753) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2008-06-12 |