| NPI | 1568726404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A134749) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125061588) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2016-02-10 |