| NPI | 1871766493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036-150920) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 115156) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2025-11-05 |