| NPI | 1598178451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 66272) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125064543) |
| 208600000X Surgery (Licence: CA A170475) | |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-08-18 |