| NPI | 1700377033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036165552) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP04240) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036165552) | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-09-09 |