| NPI | 1275617839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036-096029) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01074235A) |
| 208600000X Surgery (Licence: TX K8818) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2021-11-30 |