| NPI | 1083753677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX N3303) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: IL 036-113647) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-09-19 |