| NPI | 1598020174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036150263) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301101431) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-04-14 |