| NPI | 1366589194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036093310) | 
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036093310) | 
| 2086S0127X Surgery, Trauma Surgery (Licence: IL 036093310) | |
| Enumeration Date | 2007-01-31 | 
| Last Update Date | 2022-07-29 |