| NPI | 1780027979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036.151687) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 70012) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2023-11-13 |