NPI | 1811754898 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-010554) |
Enumeration Date | 2024-03-05 |
Last Update Date | 2025-04-25 |