| NPI | 1003916883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: LA 322549) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036116676) |
| 208600000X Surgery (Licence: AZ 42464) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-06-01 |