| NPI | 1346923034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085009976) |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-06-11 |