| NPI | 1821355363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036166916) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301110434) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2025-09-04 |