| NPI | 1477524502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036164922) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036164922) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2020010905) | |
| 208600000X Surgery (Licence: TX L7669) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TX L7669) | |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2026-09-22 |