| NPI | 1699117358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 125063364) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-146422) |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2021-03-05 |