| NPI | 1992906218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 113000049) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: IL 113000049) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2023-01-12 |