| NPI | 1144670936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX 48537) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.069030) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2024-12-05 |