| NPI | 1902364508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036177274) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301511546) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2025-10-31 |