| NPI | 1316204266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other Surgical Assistant (Licence: IL 237000110) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: IL 237000110) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2020-05-29 |