| NPI | 1558742890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036152517) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125066670) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2020-07-27 |