| NPI | 1598256265 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036-171659) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT215445) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-01-09 |