| NPI | 1558563205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2016-00193) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036116803) |
| 208600000X Surgery (Licence: MO 2009019133) | |
| 2086X0206X Surgery, Surgical Oncology (Licence: NC 2016-00193) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2022-07-21 |