| NPI | 1396723748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 45847) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 048275) |
| 208600000X Surgery (Licence: IL 036118870) | |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2010-09-15 |