| NPI | 1568422012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036108563) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036108563) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2021-03-19 |