| NPI | 1790719219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: OR MD218121) |
| Additional Taxonomies | 2086S0129X (Licence: IL 036085648) |
| 2086S0129X (Licence: MT 18479) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2024-02-14 |