NPI | 1780997197 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 036059978) |
Additional Taxonomies | 174400000X Specialist (Licence: IL 036059978) |
Enumeration Date | 2010-07-15 |
Last Update Date | 2024-09-30 |