| NPI | 1851387120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036-060541) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: IL 036-060541) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2022-06-15 |