| NPI | 1437588555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036133729) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036.133729) |
| 208600000X Surgery (Licence: IL 036.133729) | |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2024-08-01 |