| NPI | 1467080630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036178629) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30808) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2026-08-02 |