| NPI | 1043432842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: HI MD 13768) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-115406) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-04-26 |