| NPI | 1962502740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301095765) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036096272) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2026-04-03 |