| NPI | 1184848913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD-060707-L) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA c51194) |
| 208600000X Surgery (Licence: IL 036.127816) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2014-09-03 |