| NPI | 1558399238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD062496L) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036138105) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-12-20 |