| NPI | 1003993064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD175340) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036069953) |
| 2086X0206X Surgery, Surgical Oncology (Licence: IL 036-069953) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-02-25 |