| NPI | 1306874466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2006012811) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036123385) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-05-21 |