| NPI | 1538517719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036147851) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.147851) |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2026-06-30 |