| NPI | 1528269214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 2015033187) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036127430) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2024-03-28 |