| NPI | 1225041361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: RI MD12407) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036-100414) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2008-01-21 |