| NPI | 1376975185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036160530) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A144539) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2023-01-13 |