| NPI | 1346636479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: AL MD.54394) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036155569) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2026-08-03 |