| NPI | 1457369480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IL 036-119853) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 37422020) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2016-11-07 |