| NPI | 1497192785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2024041767) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036154307) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2024-11-07 |