| NPI | 1033600721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 81346-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.072496) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2023-12-26 |