| NPI | 1790770618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2088P0231X (Licence: IL 036050075) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036-096912) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2016-05-19 |