| NPI | 1932392099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036119986) |
| Additional Taxonomies | 208600000X Surgery (Licence: DC MD036123) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-03-31 |