| NPI | 1689637472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: IL 036138914) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D63677) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2021-05-06 |