| NPI | 1376525550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036127019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G88065) |
| 208D00000X General Practice (Licence: TX G0760) | |
| 208600000X Surgery (Licence: IL 036127019) | |
| 208D00000X General Practice (Licence: CA G88065) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2025-01-21 |