| NPI | 1780241059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036176360) |
| Additional Taxonomies | 208600000X Surgery (Licence: RI LP04590) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036176360) | |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2025-08-13 |