| NPI | 1891323812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036181632) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: IL 036181632) |
| 208600000X Surgery (Licence: MI 4301513902) | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-08-12 |