| NPI | 1518428903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD200001374) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125073939) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-04-28 |