| NPI | 1801283270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036146742) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125066335) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2022-09-09 |