| NPI | 1114123163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: TX N4276) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-118605) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2010-01-07 |